© 2015 Informa UK Ltd. Objective: The objective of this series is to describe the clinical features and immediate outcomes of surgically managed perinatal testicular torsion (PTT).Methods: A retrospective chart review of the cases of PTT diagnosed in neonates less than 1 month of age was conducted. The cases were identified from the hospital database maintained prospectively over 24 years at the sole tertiary referral centre for the state of Western Australia.Results: Twenty eight cases of PTT were identified, being 23 unilateral and 5 bilateral. All the five bilateral cases were asynchronous and three were identified incidentally on surgical exploration of unilateral torsion. The testis was clinically salvaged in two newborns at the time of follow-up.Conclusion: Asynchronous bilateral PTT could be missed on physical examination and identified on surgical exploration of unilateral PTT. Emergency exploration may result in salvage of the contralateral torted testis.